Stephanie  R  Brown    RPT
Contract Details
Donahoo Physical Therapy
Facility name
Provider ID
P000007779
NPI
1255375911
Tax ID
465009092
Effective Date
4/1/2014
Last Updated
5/13/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
114 West Fort Williams Street
Sylacauga, AL 35150
United States
County
Talladega
Phone
2564048478 (Phone)
Billing Details
Address
114 West Fort Williams Street
Sylacauga, AL 35150
Billing Phone
2564048478
Specialty Type
Physical Therapy
Map
Address